The Dangers of Hymenotomy for Imperforate Hymen A Case of Iatrogenic Pelvic Inflammatory Disease with Pyosalpinx

Complications associated with imperforate hymen include cyclical abdominal pain, acute urinary retention, endometriosis, and even iatrogenic infections.CASE: A 14 year old female was diagnosed with an imperforate hymen, hematocolpos, and right hematosalpinx. A hymenotomy was performed, followed by a hymenectomy three days later. On postoperative day 7, she was admitted for pelvic inflammatory disease with a right pyosalpinx. The infection was refractory to intravenous gentamicin, ampicillin, and clindamycin so the patient underwent computerized tomography guided drainage of the pyosalpinx. Two days later, she was discharged home in good condition.Small incisions and punctures into imperforate hymens without immediate definitive management should be avoided since inoculation of the newly introduced bacteria can ascend the gynecologic tract and lead to serious infections.